Implementation and compliance with the sepsis six bundle in the emergency department: A quality improvement project in a resource-limited tertiary care setting

Objective: To assess compliance with the Sepsis Six bundle and its impact on clinical outcomes in patients presenting with sepsis in the emergency department of a resource-limited tertiary care hospital. Results: A total of 200 patients were included, with 100 patients in each phase. Overall compliance with completion of all Sepsis Six components significantly improved from 29.3% pre-intervention to 73.0% post-intervention. Significant improvements were observed in all components (p-value: < 0.001). The intervention was associated with clinically important reductions in mortality (27.0% vs. 17.0%) and ICU admissions (32.0% vs. 21.0%), and a significant reduction in hospital length of stay (9.6 ± 4.1 vs. 7.2 ± 3.5 days; p< 0.001). Patients receiving incomplete bundle care had approximately threefold higher odds of in-hospital mortality than those receiving complete bundle Conclusion: Implementation of structured sepsis protocols and targeted quality improvement interventions significantly enhanced compliance and was associated with improved clinical outcomes among patients with sepsis Keywords: Sepsis, Septic shock, Sepsis six protocol.